Under-monitoring, under-treatment of AMD confirmed by real-life studies
LISBON, Portugal — Real-life studies carried out in different countries confirmed that age-related macular degeneration patients who require intravitreal anti-VEGF injections are under-monitored and under-treated.
“Several studies already published, including LUMIERE, AURA, WAVE and Coimbra, as well as Medicare data, seem to indicate that this is the scenario all over the world,” Rufino Silva, MD, said at the Controversies in Ophthalmology meeting.
The studies looked at the results of real-world clinical practice and revealed a scenario that is different from what should be expected by following the recommendations of clinical trials.
“Results are frankly disappointing,” Silva said. “The problem could be related with the fact that hospitals, potentially overloaded by the increasing number of AMD patients needing treatment, are unable to organize appropriate schedules for patients. The number of injections is therefore less than the recommended seven to eight in the first year and tends to drop even further in the following years. It’s a widespread problem, which might become even greater in the future. We need to reconsider the way we treat.”
A solution now adopted in his department in Coimbra, Portugal, is to fix all the yearly appointments during the first visit.
“If patients take one appointment at a time, it is often difficult to find a time slot within a month, and the chain of delays and irregular visits starts from the beginning,” Silva said.
Disclosure: Silva is a consultant to Novartis, Bayer, Théa, Allergan, Alcon and Alimera.